Abstract
Civilian–military collaboration in humanitarian crises has been encouraged globally; however, little is known about their diverse ethical viewpoints towards challenging and critical situations, which may cause difficulties in the partnership, and influence the outcomes of their mutual activities. The aim of this study was to identify the diversity of viewpoints and ethical decision-making during exceptional circumstances among civilian and military populations from two different countries, each with diverse background and healthcare organization structures. Possible scenarios, based on a systematic review of the literature, were introduced to Swedish and Polish civilian and military healthcare providers. Variations in the participants’ viewpoints and approaches to ethical decision-making were analyzed according to their characteristics, organizational belonging, and nationality. There were differences between both populations but also within the military and civilian groups, respectively. One significant factor influencing ethical viewpoints was participants’ nationality. Differences in ethical viewpoints between multiagency organizations should be considered in planning and implementation of future transdisciplinary and international collaboration in disaster and emergency management. Further studies and renewed educational initiatives are necessary to validate these differences and to navigate civilian–military as well as other multinational partnerships.
Highlights
A discussion on the impact of diverse ethical viewpoints on collaborations’ outcomes is highly relevant since people live as groups in vertical and horizontal governing structures with diverse conditions
O’Fallon and Butterfield found in their review of civilian populations and organizations that gender, education, and employment factors, moral philosophy, and value orientation represented the most common factors influencing ethical decision-making, followed by nationality, cognitive moral development or ethical judgment, age, locus of control, religion, and other individual effects like competition, attitude, and self-efficiency [18]
Recent armed conflicts using new technologies, public health emergencies, and the way affected populations may behave both in nature, medically and politically, can influence the significance of civilian military collaboration and any multiagency assistance, within the healthcare systems [14,32,33,34,35,36,37]. We found it instructive to investigate the diversity of viewpoints and ethical decision-making during exceptional circumstances between the civilian and the military populations from two different countries with two diverse organizational structures and background: one with separate military healthcare (Poland) and the other without (Sweden)
Summary
A discussion on the impact of diverse ethical viewpoints on collaborations’ outcomes is highly relevant since people live as groups in vertical and horizontal governing structures with diverse conditions. While the vertical governing structure advocates rules and regulations and offers limited personal independence, the horizontal structure allows more space for personal judgment and interpretations (military vs civilian organization) [1,2] Both structures confront critical situations in need of vital and ethically justifiable decisionmaking. Ethics incorporate concerns about the conduct of war, decisions on how and when to engage in military operations, and issues relating to the moral psychology and care of those who serve and of veterans of military service These interface with values and virtues [20,21]. All these virtues of character result in a formidable feeling of “can do” and practical wisdom, which leads to actions that enable the military to overcome ethically sensitive situations with proper ethical decision-making
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